Successful Management of a Very Unusual Coronary Pattern in Transposition of the Great Arteries

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Successful arterial switch operation (ASO) for transposition of the great arteries (TGA) relies heavily on accurate coronary artery anatomy.
• Variations in coronary artery origins can complicate ASO, necessitating meticulous pre-operative planning and intra-operative adaptation.

Observation:

• A unique coronary artery pattern was observed in a pediatric patient diagnosed with TGA.
• In this case, all three major coronary arteries originated from separate aortic sinuses.
• This specific coronary anomaly has not been previously documented in the context of TGA.

Findings:

• The identified coronary pattern represents a novel anatomical variation in TGA.
• This rare anomaly poses significant technical challenges during the arterial switch operation.
• Precise identification and management of such variations are critical for surgical success.

Implications:

• This case highlights the importance of detailed pre-operative imaging to identify rare coronary patterns in TGA patients.
• Surgeons must be prepared to adapt surgical strategies for complex coronary anatomy during ASO.
• Reporting such anomalies contributes to a better understanding of TGA variations and improves surgical outcomes.